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The Failure of Rhythm and 'Just Say No'

The rhythm method -- that is, having sex only during a woman's "safe period" when she is not ovulating -- was widely recommended by doctors. But doctors had it wrong. Based on animal observations, they thought women were "safe" at the midpoint of their menstrual cycle. This is precisely when women are most likely to conceive. So women who could afford medical advice actually were told to have sex at the exact time they were most likely to become pregnant.

Similarly, another early effort at behavioral birth control failed during the first World War. Dismayed at the high rates of sexually transmitted disease that were disabling their soldiers, armies and navies issued condoms to their fighting men. The U.S., however, attempted to teach "continence" -- that is, abstinence -- to their troops. Few U.S. troops obeyed this command, and many obtained condoms while abroad.

Ironically, these likely were American-made condoms, as the war made U.S. manufacturers the leaders in the field. After the war, soldiers brought their new-found knowledge home with them. Condoms became legal in 1918, the same year the war ended.

Tone sees a lesson in this experience.

"We are way behind in what we say to young people," she says. "The best example is World War I, where the official government line was that abstinence would make you stronger. But no more than 30% of soldiers were abstaining.

"We saw this in the Reagan era with the just-say-no approach to drugs, and this has carried over to sex," she continues. "We would prefer to think young people would be able to resist these urges that are universal, and we fool ourselves. We spend less money on birth control because we think if a person does get pregnant or an STD, it is just their own fault -- they weren't disciplined enough."

By the 1920s, the U.S. birth rate dropped by half -- statistical evidence that the explosion of condom sales and a more modern approach to the rhythm method were in widespread use. Condom reliability was still terrible by modern standards -- but people achieved effective birth control by combining use of condoms, the rhythm method, male withdrawal, diaphragms, and/or intrauterine devices.